Question

How would you interact with the patient who shared suicidal ideation with you?

Discuss three approaches you might use in this situation. This should include a paragraph for each approach and should include evaluation of if you perceive their approaches are useful, or if you would modify the approach, and if so how and why.

Answer 1

three approaches that canbe used to   interact with the patient who shared suicidal ideation:

A collaborative care approach strives to provide optimal care for patients.

While a multidisciplinary approach to suicide risk assessment and management has been identified as important for reducing suicide, standard clinical guidelines for such an approach do not exist. Proposed is the adoption of the therapeutic risk management of the suicidal patient (TRMSP) to improve suicide risk assessment and management within multidisciplinary systems of care.

The TRMSP involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. When structured instruments are combined with clinical risk assessment, the incorporation of suicide-specific structured instruments offers an approach to suicide risk assessment, with risk assessment as a process as opposed to an event. Patients who present with risk will require additional suicide risk assessments.

Therapeutic risk assessment of the suicidal patient requires moving beyond the 1-dimensional stratification of suicide risk that has traditionally been predicted on low, moderate, or high. A multidisciplinary approach to TRMSP requires a standardization nomenclature that facilitates consistent documentation and communication between providers and creates a cohesive medical record.

The third component involves the safety planning intervention (SPI). The SPI is an alternative approach to the no-suicide contracts. The SPI consists of 6 steps: warning signs, internal coping strategies, people and social settings that provide distraction, contact family or friends to help resolve a crisis, contact professionals or agencies to help with crisis, and reduce the potential for use of lethal means.

The SPI along with the suicide risk assessment is ongoing. Safety plans are the property of the patient but should be visible to all the providers. In creating the multidisciplinary approach to the TRMSP for systems of care, the goal will be to surround suicidal patients with a network of providers who cooperatively optimize care and mitigate risk.